Emergency HeartWare Ventricular Assist Device (HVAD) exchange due to pump thrombosis using minimally invasive technique

Left ventricular assist device (LVAD) thrombosis remains a dreadful complication of mechanical circulatory support, with an incidence of 8-12% depending on the pump type and patient's comorbidities. Fibrinolysis may be considered early in pump thrombosis, but when contraindicated a pump exchang...

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Bibliographic Details
Published in:Kardiochirurgia i torakochirurgia polska 2017-01, Vol.14 (1), p.76-78
Main Authors: Antończyk, Remigiusz, Trejnowska, Ewa, Pacholewicz, Jerzy, Wolny, Tomasz, Nadziakiewicz, Paweł, Antończyk, Karolina, Copik, Izabela, Piontek, Magdalena, Jasińska, Małgorzata, Filipiak, Krzysztof, Głowacki, Maciej, Gawlikowski, Maciej, Borowicz, Marcin, Kustosz, Roman, Waszak, Jacek, Przybyłowski, Piotr, Zembala, Marian, Zakliczyński, Michał, Zembala, Michał Oskar
Format: Article
Language:English
Subjects:
Case Report
Fibrinolysis
Heart transplantation
Hemorrhage
Pumps
Stroke
Surgery
Thorax
Thrombosis
Transplantation
Trauma
Ventricle
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Summary:Left ventricular assist device (LVAD) thrombosis remains a dreadful complication of mechanical circulatory support, with an incidence of 8-12% depending on the pump type and patient's comorbidities. Fibrinolysis may be considered early in pump thrombosis, but when contraindicated a pump exchange remains the only alternative. This short report documents an emergency LVAD exchange in a 55-year-old man who underwent LVAD (HeartWare Inc) implantation in 2013 as a bridge to transplantation. Four months after the initial surgery, he suffered from a hemorrhagic stroke despite properly managed anticoagulation. On February 17 , 2017 he was re-admitted with LVAD pump thrombosis. As fibrinolysis was contraindicated, an emergency pump exchange was performed via a limited thoracic incision in order to minimize surgical trauma, reduce intraoperative complications and facilitate immediate post-operative recovery. This report documents the very first LVAD pump exchange as well as the first one performed via a minimally invasive approach in Poland.
ISSN:1731-5530
1897-4252
DOI:10.5114/kitp.2017.66938